Rapid onset renal deterioration in an adult with silent ureteropelvic junction obstruction

We report a case of a rapid renal deterioration due to ureteropelvic junction obstruction (UPJO) in an asymptomatic woman with prior normal diuretic renography. This case illustrates “silent” renal obstruction and the inability of diuretic renography in detecting significant renal obstruction. This case may favor close surveillance of any adult patient with potential UPJO, especially those with underlying renal disease or solitary kidney.